Comparing the effect of active and expectant managements of the second stage of labor on perineal status


Fatemeh Rahimikian 1 , Forough Talebi 2 , * , Shahnaz Golian Tehrani 1 , Abbas Mehran 3

1 Instructor Department of Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

2 Instructor Department of Biostatistics, Tehran University of Medical Sciences, Tehran, Iran.

3 Instructor Department of Midwifery, Islamic Azad Universty, Tehran Branch, Tehran, Iran.

How to Cite: Rahimikian F , Talebi F , Golian Tehrani S , Mehran A . Comparing the effect of active and expectant managements of the second stage of labor on perineal status, Hormozgan Med J. 2015 ; 19(3):e87452.


Hormozgan Medical Journal: 19 (3); e87452
Published Online: December 18, 2013
Article Type: Research Article
Received: July 03, 2013
Accepted: December 18, 2013




Introduction: Pregnancy and parturition process affects considerably the society’s
health. Female genital injuries caused by vaginal parturition are very prevalent. This study
aims at comparing active and expectant managements of the second stage of labor on
frequency of perineal injuries and using episiotomy, as a solution.
Methods: In this quasi-experimental study, a total of 160 qualified pregnant women,
diagnosed by a qualified physician, were divided into one of two groups, expectant
management group (experimental group, n=80) and active management group (control
group, n =80). For the experimental group, in the second stage of labor, researcher did
not touch the perineum before the baby’s head delivered and just supported the frontal
area and urethra. For the control group, the researcher supported perineum using Ritgen
Maneuver. Data were analyzed using SPSS 16, T-test, Fisher’s exact test and Chi-
Squared test.
Results: In the experimental group, women’s perinea were significantly healthier than
those of women in the control group (P<0.001) (38.8% vs. 10%); however, there was
not a significant difference between two groups in terms of spontaneous rupture. Need to
perform episiotomy in experimental group was 33.8%; whereas control group members’
need to episiotomy was 66%, which it was a significant difference (P<0.001).
Conclusion: The expectant management of the second stage of labor (perineal control
with hand-off technqiue) is accompanied with fewer perineal injuries; therefore, it can be
used as a safe technique by the birth centers.


Labor – Episiotomy – Perineum

© 2015, Hormozgan Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.



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